Abstract P1-05-04: Physician Practice Patterns of Breast Imaging After Treatment: Survey of Real-World Practice
Authors: Meredith Whittaker, Kiah Farr, Preethika Potluri, Nova Foster, Jennifer Erdrich, Jennifer Segar, Sima Ehsani, Sao Jiralerspong, Denise Roe, Pavani Chalasani
Journal: Cancer Research (2023)

Abstract Introduction: Mammography is the cornerstone of breast cancer screening, diagnosis, and surveillance. After definitive treatment for breast cancer, mammograms are continued for surveillance. The current recommendations regarding surveillance after definitive treatment (surgery and radiation) lack consensus amongst various societies. There are no clear guidelines in regards to the type of mammogram recommended: diagnostic or screening mammogram or if a diagnostic mammogram is used, when to return to routine screening protocols. Current practice patterns are driven by physician’s preference. We conducted a survey to evaluate physicians’ preferences in ordering breast imaging post- breast cancer diagnosis and treatment. Methods: This survey was approved by University of Arizona institutional review board. This survey was conducted through American Society of Clinical Oncology (ASCO) voluntary opt-in Research Survey Pool (RSP). ASCO sent out this survey to 1000 randomly selected members between 10/19/2021-11/22/2021. Weekly reminders to participate were sent through the ASCO RSP for 5 weeks. Participants clicked the link to the survey platform where upon consent they completed the survey. Results: The survey was completed by 244 healthcare professionals through the ASCO RSP. Most respondents were physicians (n=228), primarily medical oncologists (n=174) and practiced in an academic environment in the United States (n=132). After definitive treatment, majority (58%) ordered first imaging at 6 months post-surgery/radiation, and it was primarily a diagnostic mammogram (68%). Interestingly, for patients at age 80 or above, screening mammogram was used for surveillance after definitive treatment by most respondents (59%). After first post-surgery/radiation mammogram there is an almost even spilt (50%) on continuing with diagnostic versus screening mammograms for follow up. Of those who order diagnostic mammograms, majority (38%) do it for 3-5 years with an additional 30% continuing it beyond 5 years. Almost 65% of respondents reported they do not stop screening mammograms at any age for patients with a history of early-stage breast cancer as long as they are healthy. Conclusions: The practice patterns of healthcare professionals as it relates to the type and frequency of breast imaging varies significantly. Despite having the same imaging quality there is a significant difference in the cost of screening and diagnostic mammograms. In addition, in clinical practice, most routine screening care is covered by insurances without co-pays or out of pocket costs for patients. Diagnostic imaging does not fall under routine screening care and frequently requires out of pocket expenses for patients. As insurance companies start to decline certain imaging modalities used for cancer detection due to lack of data supporting the use of these expensive studies, specific imaging guidelines for follow up in post-treatment setting for patients with breast cancer are needed. Citation Format: Meredith Whittaker, Kiah Farr, Preethika Potluri, Nova Foster, Jennifer Erdrich, Jennifer Segar, Sima Ehsani, Sao Jiralerspong, Denise Roe, Pavani Chalasani. Physician Practice Patterns of Breast Imaging After Treatment: Survey of Real-World Practice [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-04.